Provider Demographics
NPI:1073289401
Name:JUN, HAE IN (MA)
Entity Type:Individual
Prefix:
First Name:HAE IN
Middle Name:
Last Name:JUN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:JUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:1720 MISSION ST APT 22
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-3348
Mailing Address - Country:US
Mailing Address - Phone:408-529-5362
Mailing Address - Fax:
Practice Address - Street 1:1720 MISSION ST APT 22
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-3348
Practice Address - Country:US
Practice Address - Phone:408-529-5362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty